Date: Fri, 28 Jan 1994 09:20:40 -0500 (EST) From: "ANNE WILSON, CDC NAC" Subject: CDC AIDS DAILY SUMMARY 01/28/94 AIDS Daily Summary January 28, 1994 The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1993, Information, Inc., Bethesda, MD "Condom Controversy: How Safe Are They? Critics Are Now Asking" Washington Times (01/28/94) P. A15 (Price, Joyce) If current government policy is any indication, condoms have come a long way in the last five years. As early as February 1989, a task force comprised of such federal heavyweights as the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health issued warnings that, even with a condom, sex with an HIV-infected partner is so hazardous that "alternative methods of expressing intimacy" should be considered. Today, however, as reflected by a series of bold, new public service announcements, health officials tout condoms as "highly effective" in preventing the transmission of HIV when used "consistently and correctly." Critics of the campaign contend that it not only defies family values, but ignores scientific research documenting condom failure rates. "Condoms don't prevent HIV transmission.... They just reduce the risk," explains W. Shepherd Smith Jr., president of Americans for a Sound AIDS/HIV Policy, a group that tracks much of the condom research. "It's wrong for the government to overpromote something that's not nearly as safe as they claim when we're talking about a fatal disease." Even groups that support the condom ad campaign acknowledge that it has omitted crucial information necessary for people to protect themselves from HIV infection. "What's the deal with dancing condom without water-based lubricant--essential information--a million-dollar campaign that doesn't have essential information?" asks Wayne Turner of ACT-UP D.C. The group says the ads should clarify that condoms must be used with only water-based lubricants because oil-based lubricants cause latex condoms to deteriorate. "Saying No to Abstinence-Only Program" Washington Times (01/28/94) P. A15 (Price, Joyce) Although federal health officials concur that abstinence is the only 100 percent effective method of avoiding sexual transmission of HIV, funding for abstinence education programs continues to be cut, and abstinence-only programs are being phased out. Many reductions this year are being executed through the U.S. Public Service's Title XX program, enacted as an alternative to Title X--federal funding for contraception and abortion-related services. "The bottom line is that abstinence programs work so well; nevertheless, Title XX is being cut out and defunded," said Kathleen Sullivan, director of Project Reality, an Illinois organization that offers abstinence curricula for middle and high schools. Government sources denied this, citing that $7 million was appropriated for Title XX in fiscal 1994 and that the same amount will be sought next year. Funding, however, fell from $7.8 million in 1992 to the current $7 million in 1994. In contrast, funding for Title X for 1994 climbed to nearly $181 million. Government officials say that funding cutbacks and "terrible accountability" were the key reasons why some Title XX programs were not renewed. "Most of the programs that show any kind of major effect were more comprehensive programs," said one government official. "Girl Scout Group to be Taught About H.I.V." New York Times (01/28/94) P. A17 The Northwest Georgia Girl Scout Council, comprised of 40,000 Scouts, will teach girls aged 5 to 17 how to protect themselves from HIV infection. "We will talk about condom use in the context of prevention, but that's not to say we'll recommend having sex as long as you use a condom," notes Beth Weiss, a scout leader. "There are lots of good reasons for adolescents to put off having sex, besides the risk of getting AIDS." The girls will also learn facts and myths concerning people who are HIV-positive or have AIDS, as well as how to help them. The project is possible through a $50,000 grant to the council from Levi Strauss & Company. The two-year grant will be used to train staff members and volunteers on how to educate the girls. "We've decided to do this because of the statistics related to women in Georgia," says council leader Judi Borgo, noting that women were one of the fastest-growing segments of the HIV population. "Johnson's Lawyer Threatens to Sue" New York Times (01/28/94) P. B13 The attorney of former U.S. basketball star Magic Johnson has threatened to sue an Indonesian sports promoter for canceling Johnson's visit to the country. The organizer, Point Promotion, on Tuesday called off exhibition games in which the retired Los Angeles Laker was to play, after the director of immigration announced that Johnson would be barred entry to Indonesia because of his HIV infection. Johnson and his team had been scheduled to play two games there on Feb. 26 and 27, and the promoter--who paid nearly $100,000 as a down payment on the team's $379,000 fee--still hopes to have them play. "Fears Mount of AIDS Toll Among Addicts" Boston Globe (01/27/94) P. 21 (Murphy, Sean P.) Public health officials in Massachusetts say that HIV is spreading faster among intravenous drug users and their sex partners than any other high-risk category in the state. An estimated 25 to 40 percent of the 40,000 to 60,000 IV-drug users in Massachusetts may be infected, speculate drug treatment providers. State epidemiologists have documented an increase in actual AIDS cases among this group from 259 in 1989 to 572 in 1992. In response to this alarming data, a modest boost in state funding for treatment of injection drug addicts was proposed last week. The $2 million increase proposed by the Weld administration is the first in five years to propose additional spending for substance abuse treatment. Drug treatment providers say that while a new budget is an important turning point, much more money is needed. "There's still much more work to be done to reach out to injection drug users," agrees Dennis McCarthy, director of the state substance abuse office. "Relocated UCSF Research Center Hosts Studies on Everything From the Effects of Cocaine on Babies to AIDS Treatments" Business Wire (01/26/94) San Francisco--The General Clinical Research Center of the San Francisco General Hospital, scheduled to officially reopen today in a new location, is a unique research facility where scientists from various disciplines can test new treatments and conduct carefully controlled studies on patients who can be monitored round-the-clock. Several investigators are using the center for clinical trials on experimental AIDS therapies, including tests of a drug known as GLQ223 and treatments for Kaposi's sarcoma, CMV retinitis, non-Hodgkins lymphoma, and lung complications in AIDS patients. One study underway by Dr. Morris Schambelan and colleagues is investigating wasting syndrome, or weight loss among AIDS patients, which is often fatal. Schambelan and collaborators have been testing bioengineered human growth hormones as a strategy for helping AIDS patients re-gain weight and prevent wasting syndrome. A study of 12 patients, published last October, concluded that the hormone may be superior to other weight-gain techniques. The General Clinical Research Center now acts as the primary testing center for a national trial of 180 AIDS patients, half of whom will receive the growth hormone and half of whom will receive placebos. "SSA Updates Guide to Social Security Benefits" Washington Blade (01/14/94) Vol. 25, No. 2, P. 25 The U.S. Social Security Administration's free booklet on benefits for HIV patients has been updated to include new rules. The new guidelines, which were published in July 1993 in the Federal Register, details what the administration defines as disabling conditions, and makes it easier for HIV-infected individuals to obtain immediate payments. Among other guidelines, the brochure identifies eligibility requirements, explains how to fill out an application, and guides readers through the process to receive Medicare and Medicaid benefits. "Concern About Diseases Fuels Moves to Conserve Blood" Modern Healthcare (01/10/94) Vol. 24, No. 2, P. 44 (Pallarito, Karen) The AIDS epidemic has sparked a renewed effort to conserve blood, experts report. According to Dr. Shelley M. Brown, director of blood bank and transfusion services at Lenox Hill Hospital in New York, "It has become more and more popular; just like any movement, it just takes time for the public to be educated about the options." Limiting blood transfusions, stockpiling blood for elective surgery, or reusing a patient's own blood are all practices that can reduce the risk of exposure to HIV and other bloodborne diseases, and also alleviate the demand on what is often an insufficient supply of donated blood in the United States. Accordingly, many patients now give blood before surgery, and most hospitals have guidelines for evaluating the appropriateness of a transfusion, Brown observes. Despite Food and Drug Administration regulations requiring all blood used in this country to be screened for the AIDS virus, it is estimated that one out of every 225,000 units of blood could be contaminated but go undetected. This is because the test used to screen for HIV measures the presence of HIV antibodies. If a blood donor's infection occurred very recently, a lag time of three weeks to six months could prevent detection of enough antibodies to test positive. To relieve anxieties about tainted blood, a handful of companies are developing blood replacements, but such products will not be on the market for years. "Home Care for AIDS Patients in Belgium" Lancet (01/15/94) Vol. 343, No. 8890, P. 166 (Owen, Ann) A hospital in Belgium has launched a palliative home care program for AIDS patients. The program will be conducted by the Saint Pierre Hospital, jointly owned by the Free University of Brussels and the local government, which reportedly treats about 50 percent of the country's AIDS patients who are under medical care. Under the home care program, the hospital will be reimbursed for sending any of its AIDS team on home visits to AIDS patients. The patient, however, does not have to pay for home care. Visiting health professionals will be trained to perform medical tasks, such as setting up IVs. They will also learn to recognize when a patient needs to be transferred to an inpatient unit. Volunteers will help provide transportation to the hospital when necessary. The program also accepts infected drug addicts, but arrangements to undergo rehabilitation are made through a separate service. So far, 72,000 people in Belgium have been confirmed as HIV-positive, and another 15,000 to 20,000 are thought to be infected. If the hospital administration has accurately predicted the number of future patients, the project, which is not designed to make money, will support itself. Other hospitals may be eligible for similar programs with the national health service if they have the required minimum of AIDS patients in their clinics. "Pneumocystis Carinii Pneumonia in Children With Perinatally Acquired HIV Infection" Journal of the American Medical Association (01/12/94) Vol. 271, No. 2, P. 102 (Simonds, R. J.) Dr. R.J. Simonds of the Centers for Disease Control responded to critics challenging his study on pneumocystis carinii pneumonia in children with perinatally acquired HIV. Epps et al. questioned Simonds' calculation that median survival age for such children was 19 months--a period they observed to be far greater that what has been noted in other studies. They pointed out that Simonds' data did not indicate a significant difference in survival for infants compared to older children. Simonds responded that the relationship between age and survival has yet to be clarified. Also, using either 6-month or 12-month cutoffs, Simonds said he failed to detect any significant difference in survival among younger and older children. Dr. Wendy Chavkin of Beth Israel Medical Center in New York wondered if Simonds had considered the consequences of recommending that potentially HIV-infected infants be identified after birth. Women fearing discriminatory consequences would avoid health care. In addition, she says, this practice would jeopardize the ability to conduct surveillance activities. Simonds said Chavkin misinterpreted the conclusions. To effectively prevent PCP, children born to HIV-infected mothers need to be identified as early as possible so that prophylaxis can begin before the period of highest risk for PCP. Thus, he counters, HIV testing and counseling should be encouraged for all pregnant women at high risk for HIV.